{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T08:46:15Z","timestamp":1775292375149,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,16]],"date-time":"2020-02-16T00:00:00Z","timestamp":1581811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008322","name":"CSL Behring","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001779","name":"Monash University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Massive obstetric haemorrhage (MOH) is a leading cause of maternal morbidity and mortality world\u2010wide. Using the Australian and New Zealand Massive Transfusion Registry, we performed a bi\u2010national cohort study of MOH defined as bleeding at \u226520\u00a0weeks\u2019 gestation or postpartum requiring \u22655 red blood cells (RBC) units within 4\u00a0h. Between 2008 and 2015, we identified 249 cases of MOH cases from 19 sites. Predominant causes of MOH were uterine atony (22%), placenta praevia (20%) and obstetric trauma (19%). Intensive care unit admission and\/or hysterectomy occurred in 44% and 29% of cases, respectively. There were three deaths. Hypofibrinogenaemia (&lt;2\u00a0g\/l) occurred in 52% of cases in the first 24\u00a0h after massive transfusion commenced; of these cases, 74% received cryoprecipitate. Median values of other haemostatic tests were within accepted limits. Plasma, platelets or cryoprecipitate were transfused in 88%, 66% and 57% of cases, respectively. By multivariate regression, transfusion of \u22656 RBC units before the first cryoprecipitate (odds ratio [OR] 3\u00b75, 95% CI: 1\u00b77\u20137\u00b72), placenta praevia (OR 7\u00b72, 95% CI: 2\u00b70\u201326\u00b74) and emergency caesarean section (OR 4\u00b79, 95% CI: 2\u00b70\u201311\u00b77) were independently associated with increased risk of hysterectomy. These findings confirm MOH as a major cause of maternal morbidity and mortality and indicate areas for practice improvement.<\/jats:p>","DOI":"10.1111\/bjh.16524","type":"journal-article","created":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T05:20:07Z","timestamp":1581916807000},"page":"618-628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Haematological features, transfusion management and outcomes of massive obstetric haemorrhage: findings from the Australian and New Zealand Massive Transfusion Registry"],"prefix":"10.1111","volume":"190","author":[{"given":"Masa","family":"Lasica","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Vic Australia"},{"name":"Australian Red Cross Blood Service Melbourne Vic Australia"},{"name":"Department of Haematology Eastern Health Melbourne Vic Australia"},{"name":"Department of Haematology St Vincent\u2019s Hospital Melbourne Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemary L.","family":"Sparrow","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Tacey","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy E.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Maternal Critical Care Melbourne Vic Australia"},{"name":"School of Nursing and Midwifery La Trobe University Melbourne Vic Australia"},{"name":"Department of Nursing The University of Melbourne Melbourne Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica M.","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Vic Australia"},{"name":"Department of Haematology Monash Health Melbourne Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9698-7185","authenticated-orcid":false,"given":"Zoe K.","family":"McQuilten","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine Monash University Melbourne Vic Australia"},{"name":"Australia and New Zealand Intensive Care Research Centre (ANZIC\u2010RC) Melbourne Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the members of the Australian\u00a0and New Zealand Massive Transfusion Registry\u00a0Steering 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